Timing of milk expression following delivery in mothers delivering preterm very low birth weight infants: a randomized trial



To determine the effect of timing of expression initiation on mother’s own milk production and time to secretory activation in mothers of preterm infants.

Study design

180 mothers delivering infants ≤1500 grams and ≤32 weeks gestation were randomized to begin expression within 60 (early), 61–180 (intermediate) or 181–360 (late) minutes following delivery. Milk volume was measured on days 1–7 and weekly for 6 weeks. Time to secretory activation was determined through self-report.


The late group produced more milk than the early group in the first 3 days (p = 0.015–0.031) and over 6 weeks (p = 0.045). The late group had more expressions on day 1 (early: p = 0.049; intermediate; p = 0.048).


Initiation of expression at 181–360 min following delivery was associated with increased milk production for 6 weeks following delivery. Further research is needed to determine the effect of expression frequency on milk production in the first days following birth.

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This work was supported by a grant 1 R15 NR013566-01A1 from the National Institute of Nursing Research.

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Correspondence to Leslie A. Parker.

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LAP, SS, CK and MM’s work has been funded by the NIH. None of the authors have additional conflict of interests.

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Parker, L.A., Sullivan, S., Kruger, C. et al. Timing of milk expression following delivery in mothers delivering preterm very low birth weight infants: a randomized trial. J Perinatol 40, 1236–1245 (2020). https://doi.org/10.1038/s41372-020-0688-z

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